影响下颌第三磨牙的冠状切除术:临床和放射学回顾性病例系列研究,随访 2-9 年。

IF 2.2 3区 医学
J-C Bernabeu-Mira, D Peñarrocha-Oltra, M Peñarrocha-Diago
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引用次数: 0

摘要

背景:受撞击的下颌第三磨牙偶尔会与下牙槽神经(IAN)密切相关。有人认为冠状切除术是防止下牙槽神经损伤的一种很好的替代方法。本研究评估了下颌第三磨牙撞击的临床和放射学结果,这些下颌第三磨牙的放射学表现与下牙槽神经损伤的高风险有关,并采用冠状切除术进行了治疗:一项回顾性病例系列研究评估了下颌第三磨牙冠状切除术的疗效。纳入标准包括:术前、术后即刻和两年的全景X光片、术前锥束计算机断层扫描(CBCT)以及完整的病史。临床评估包括术中并发症(移动的牙根碎片和邻近结构损伤)、短期并发症(感觉改变和术后感染)和长期并发症(感染或口腔暴露)。此外,还对IAN相对于牙根的位置、牙根形状、萌出状态、第三磨牙位置、根尖复合体移位和牙根上方的骨质进行了放射学评估:从 2011 年到 2022 年,共拔除了约 2000 颗下颌第三磨牙。其中,34 名患者的 39 颗臼齿采用冠切术进行了部分拔除。平均年龄为 36 岁(22-77 岁不等),平均随访时间为 28 个月(24-84 个月不等)。术后有两次短期感染。其中一例在抗生素治疗后通过再次手术切除牙根得到了解决,另一例则需要入院并切除牙根。此外,还记录了一例短期短暂的舌麻痹。发现了两例长期口腔暴露,必须拔除牙根碎片。没有永久性的感觉改变:在我们的病例系列中,有 39 颗下颌磨牙与 IAN 紧密接触,并采用牙冠切除术进行治疗,并发症较少(两例感染和一例短暂的舌麻痹),也没有观察到永久性的感觉改变。需要进行前瞻性研究,特别是随机临床试验,以比较该技术与传统拔牙术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Coronectomy of impacted mandibular third molars: a clinical and radiological retrospective case series study with 2-9 years of follow-up.

Background: Impacted mandibular third molars occasionally are in intimate relation to the inferior alveolar nerve (IAN). Coronectomy has been proposed as a good alternative to prevent injury of the IAN. The present study evaluates the clinical and radiological outcomes of impacted mandibular third molars presenting radiographic signs associated with a high risk of IAN injury, and which were treated with the coronectomy technique.

Material and methods: A retrospective case series evaluated the outcomes of coronectomies of impacted mandibular third molars. The inclusion criteria were: available preoperative, immediate postoperative and two-year panoramic radiographs, preoperative cone-beam computed tomography (CBCT), and a complete case history. The clinical evaluation comprised intraoperative complications (mobilized fragments of root and damage to adjacent structures), short-term complications (sensory alterations and postoperative infection), and long-term complications (infection or oral exposure). The IAN position with respect to the roots, root shape, eruption status, third molar position, radicular-complex migration and bone above roots were radiographically evaluated as well.

Results: Approximately a total of 2000 mandibular third molars were removed from 2011 to 2022. Of these, 39 molars in 34 patients were partially extracted using the coronectomy technique. The mean age was 36 years (range 22-77), and the mean follow-up was 28 months (range 24-84). There were two short-term postoperative infections. One of them was resolved through reintervention to remove the roots after antibiotic treatment, while the other required hospital admission and removal of the roots. One case of short-term transient lingual paresthesia was also recorded. Two long-term oral exposures were detected, and the root fragments had to be extracted. There were no permanent sensory alterations.

Conclusions: In our case series of 39 impacted mandibular molars in intimate contact with the IAN and treated with the coronectomy technique, the number of complications was low (two infections and a single case of transient lingual paresthesia), and no permanent sensory alterations were observed. Prospective studies, especially randomized clinical trials, are needed to compare this technique with conventional extraction.

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来源期刊
CiteScore
4.50
自引率
0.00%
发文量
52
期刊介绍: 1. Oral Medicine and Pathology: Clinicopathological as well as medical or surgical management aspects of diseases affecting oral mucosa, salivary glands, maxillary bones, as well as orofacial neurological disorders, and systemic conditions with an impact on the oral cavity. 2. Oral Surgery: Surgical management aspects of diseases affecting oral mucosa, salivary glands, maxillary bones, teeth, implants, oral surgical procedures. Surgical management of diseases affecting head and neck areas. 3. Medically compromised patients in Dentistry: Articles discussing medical problems in Odontology will also be included, with a special focus on the clinico-odontological management of medically compromised patients, and considerations regarding high-risk or disabled patients. 4. Implantology 5. Periodontology
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